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Individual

DIANA KIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
5060 LOGAN AVE, SAN DIEGO, CA 92113-3014
(310) 817-1898
Mailing address
9819 FIELDTHORN ST, SAN DIEGO, CA 92127-4413
(310) 817-1898

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
63098
CA

Other

Enumeration date
01/04/2014
Last updated
07/21/2014
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